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Question for Doctors: What is "protocrit"?

Goshawk

Graduate Poster
Goshawk
Joined
Jan 25, 2003
Messages
1,451
I work at Walgreens as a pharmacy technician, and the other day a man came in and had to pay $2,200 (yes, that's twenty-two hundred dollars) for an injection of "Protocrit" for his wife (it wasn't covered by his insurance). Googling it isn't helping me; anybody know what it is, and what it's for?

Thanks in advance.
 
Goshawk said:
I work at Walgreens as a pharmacy technician, and the other day a man came in and had to pay $2,200 (yes, that's twenty-two hundred dollars) for an injection of "Protocrit" for his wife (it wasn't covered by his insurance). Googling it isn't helping me; anybody know what it is, and what it's for?

Thanks in advance.
Click to expand...

You didn't find it by Googling since it is spelled wrong. It is PROCRIT or epoetin alfa. It is erythropoietin, a red blood cell stimulating glycoprotein that is used for treatment of severe red blood cell anemia such as frequently is seen in kidney dialysis patients, cancer chemo patients and
other types of disorders that cause severe anemia. It is touted as a safer alternative to frequent blood transfusion and has made a difference but is, as you saw, a lot more expensive.

The name of the drug derives from "pro--", favoring/for and crit, short for hematocrit which is a measure of the solid portion of the blood which is primarily red blood cells.

Check out:

www.procrit.com

edited to add:

"protocrit" is a term very rarely used to describe pre-filtration hematocrit values on dialysis; it derives from "proto" = prior or preliminary, hematocrit.
 
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SteveGrenard said:
You didn't find it by Googling since it is spelled wrong. It is PROCRIT or epoetin alfa. It is erythropoietin, a red blood cell stimulating glycoprotein that is used for treatment of severe red blood cell anemia such as frequently is seen in kidney dialysis patients, cancer chemo patients and
other types of disorders that cause severe anemia. It is touted as a safer alternative to frequent blood transfusion and has made a difference but is, as you saw, a lot more expensive.

The name of the drug derives from "pro--", favoring/for and crit, short for hematocrit which is a measure of the solid portion of the blood which is primarily red blood cells.

Check out:

www.procrit.com
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Hello, Steve.

Long time, eh?

Let's have fun.
 
Goshawk said:
I work at Walgreens as a pharmacy technician, and the other day a man came in and had to pay $2,200 (yes, that's twenty-two hundred dollars) for an injection of "Protocrit" for his wife (it wasn't covered by his insurance).
Click to expand...
It's at moments like this that I realise I love the NHS, really.

Rolfe.

PS. Claus, why do you have to be so belligerent? Steve gave a perfectly correct and informative answer. Just because you have a history there (and you ain't the only one, remember), doesn't mean you have to behave like a hovering buzzard!
 
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Apropos Bikewer's comment, Rolfe, isn't this class of drug also used to "blood dope" race horses?
 
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Yes, but it's pointless.

Unlike man, the horse has a contractile spleen, which is just sitting there ready to dump lots and lots of stored erythrocytes into the circulation when sprinting. It's under adrenergic control, and it's particularly well-developed in the thoroughbred racehorse. These damn animals can have a PCV of 0.75 or over at the end of a race, compared to resting of half that. We even had to take extra quantities of blood for biochemistry on these samples just to get enough plasma to run the tests!

This is basically a natural and endogenous form of "blood doping", which is safe because the high PCV is only present during the actual exercise. Against this background, either blood doping or the use of erythropoietin are a complete waste of time and money.

However, some people know so little about the physiology of what they're trying to achieve that they'll blindly try anything that has been tried on human athletes. Their loss.

Rolfe.
 
Thanks. I guess few people know about this property of horse spleens.

Do you know about the following case?

http://sport.guardian.co.uk/horseracing/story/0,,1722235,00.html

I was wondering what this guy was trying to do exactly. Snake venoms depending on type have both anti and procoagulant properties. A subfactor in Malayan Pitviper venom is being clinically tested to stop bleeding in people so I was wondering if this trainer was thinking he could do the same thing in horses using any old whole venom? If so, are you aware if this practice is commonplace or is this case just a one of a kind type of idioacy.

Thanks again ....
 
Thanks, Steve. :)

I somehow doubt the guy's wife is using it for athletic enhancement; chemo or severe anemia sounds more like it.
 
It may well be a case of chronic kidney failure on dialysis. I just hope the insurance covers the dialysis!

Rolfe.
 
Goshawk said:
Thanks, Steve. :)

I somehow doubt the guy's wife is using it for athletic enhancement; chemo or severe anemia sounds more like it.
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Goshawk:

I was just looking over the list of bird species that have come down with H5N1 so far. Did you know that your latin name is Accipter gentilis?
:Banane18:
 
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pgwenthold said:
So why isn't it covered by insurance?
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The short answer is that insurance company is too cheap to pay for it; the long answer is that they have lists of excluded drugs and most/some (dont really know%s) exclude Procrit(tm) because of its cost. They point out there is a cheaper viable alternative (life before Procrit) and that's a transfusion of packed red blood cells ... which many insurance co's don't pay for either; so people are encouraged to get donors to replace transfusions or even bank their own blood which is not really an option in a chronically ill person such as a cancer chemo or dialysis patient. Doctors who manage bloodless blood replacement programs with Procrit(tm) are fighting all the time with health insurance plans to make exceptions when they can show that a transfusion of real blood could be harmful (e.g. a patient with rare subtypes that might react, etc).
 
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SteveGrenard said:
Do you know about the following case?

http://sport.guardian.co.uk/horseracing/story/0,,1722235,00.html

I was wondering what this guy was trying to do exactly. Snake venoms depending on type have both anti and procoagulant properties. A subfactor in Malayan Pitviper venom is being clinically tested to stop bleeding in people so I was wondering if this trainer was thinking he could do the same thing in horses using any old whole venom? If so, are you aware if this practice is commonplace or is this case just a one of a kind type of idioacy.
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This is pretty irrelevant, it's not a performance enhancer. The article sort of explains it.
Compounds containing snake venom have been used to treat bleeding problems, including haemophilia, in humans in recent years, and are known to be used on horses in training as an aid to stop them bleeding internally during exercise. The substance Bute is used in much the same way but, like venom derivatives, must have cleared a horse's system by the time it gets to a race.
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Horses quite often "break a blood vessel" during the race, and bleed from the nose. I've never heard of this as a treatment, but the article seems to think it's commonly used. I can scarcely believe that a racehorse trainer was unaware of the rule about not giving horses any foreign substances before a race, but this guy seems to have convinced the jury, lucky him.

Howeve, the comparison with "Bute" (phenylbutazone) is invalid, phenylbutazone is a non-steroidal anti-inflammatory drug, used as a painkiller to treat lameness. It has nothing at all to do with haemostasis (except that, as NSAIDs go, it's pretty bad about interfering with it if you're not careful).

Rolfe.
 
Thanks for the run down on that case....so what you said first about horses' spleens is that their physiology ends up making them polycythemic but when stressed during exercise/racing they have nose bleeds but because of that physiology they recover quickly. So if this award winning trainer is blood doping his horses it is a useless, even dangerous exercise that it is illegal when done close to race time. I would like to think that the reporter or trainer also had it wrong when he said the syringe contained snake venom. It probably contained a drug derived from snake venom that contained the pro-coagulant factors in that venom rather than the whole venom itself.

Perhaps a letter to the Guardian about the use of "bute" for this purpose as well as questionning the use of "snake venom" would be in order.

Steve

Steve
 
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Rolfe,

Would NHS pay for something like procrit?

What about all hte monoclonal antibodies? I think rituximab (antibody against CD20, used for B cell cancers) costs upwards of $10,000 per month in the states. I know drugs are cheaper in the UK but its still gotta be really expensive.
 
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